Abstract: Method and systems for closing an opening formed during a medical procedure are disclosed. An example method may include advancing a needle through patient tissue to form an opening into a bile duct region, performing an intervention within the bile duct region, and advancing an embolic gel into the opening to close the opening.

Abstract: In some aspects, the present disclosure pertains to methods of treating a tissue volume comprising (a) administering an implantable composition comprising a releasable membrane-active agent to a target site such that the membrane-active agent is locally released to the tissue volume and (b) performing irreversible, reversible and/or thermal treatment by application of a pulsed electric field to the tissue volume. In other aspects, the present disclosure pertains to embolic compositions that comprise releasable membrane-active agents.

Abstract: Methods and devices for performing ablation using time multiplexed waveforms are disclosed. The increased efficacy of monophasic waveforms is combined with the reduced side effects of biphasic waveforms by distributing components of the waveform across over a broader time interval than that typically used in a conventional biphasic waveform. Charge balancing occurs upon completion of therapy delivery within a time period that avoids muscle stimulation, while allowing unbalanced waveforms to be delivered during stimulation.

Abstract: In some aspects, the present disclosure pertains to methods of treating a tissue volume comprising (a) administering an implantable composition comprising a releasable membrane-active agent to a target site such that the membrane-active agent is locally released to the tissue volume and (b) performing irreversible, reversible and/or thermal treatment by application of a pulsed electric field to the tissue volume. In other aspects, the present disclosure pertains to embolic compositions that comprise releasable membrane-active agents.

Abstract: A system for ablation is described herein including an inner electrode assembly with an inner elongate shaft and a distal electrode, an outer electrode assembly having an outer elongate shaft and a proximal electrode, wherein the outer electrode assembly defines a central passage configured to slidably receive the inner electrode assembly, wherein the distal electrode or the proximal electrode is axially moveable with respect to the other, and an energy source configured to be electrically connected to the distal electrode and the proximal electrode and configured to deliver a pulsed electric field (PEF). One of the distal electrode and proximal electrode is part of a first expandable electrode array comprising two or more electrode elements moveable between an unexpanded position and an expanded position.

Abstract: Methods and devices for performing ablation using time multiplexed waveforms are disclosed. The increased efficacy of monophasic waveforms is combined with the reduced side effects of biphasic waveforms by distributing components of the waveform across over a broader time interval than that typically used in a conventional biphasic waveform. Charge balancing occurs upon completion of therapy delivery within a time period that avoids muscle stimulation, while allowing unbalanced waveforms to be delivered during stimulation.

Abstract: Electrosurgical generators having improved functionality and a user interface. In an example, the user may modify therapy output parameters without interrupting therapy delivery within a therapy regimen by accessing a change tool on the user interface, with the change tool operable to change a stack selector configuration. In an example, the display shows both therapy amplitudes and encountered impedances for a plurality of therapy pulses in different portions of a display.

Abstract: Ablation probes and methods of their use. Example probes include probe circuits configured to provide identifying information for the probe itself. The probe circuits may sense probe usage and/or age to determine probe end of life (EOL). In response to EOL, the probe circuit generates an output indicating EOL. The probe electronic circuit may also be configured to monitor probe usage via impedance or other features, independent of such operation by an ablation pulse generator.

Abstract: One general aspect includes a system for ablation including a catheter including a sheath defining a sheath lumen and a distal end, and an elongate electrode assembly axially moveable within the sheath lumen. The electrode assembly includes a shaft defining a central channel and a distal central channel opening. The electrode assembly also includes an expandable electrode array including two or more electrode elements positioned at the distal portion of the electrode assembly, where the electrode array is moveable between a retracted position contained within the sheath lumen and an expanded position protruding from the sheath.

Abstract: Electrosurgical generators having improved functionality and user interface. In an example, the user may modify therapy output parameters without interrupting therapy delivery within a therapy regimen. In an example, the display shows both therapy amplitudes and encountered impedances for a plurality of therapy pulses in different portions of a display. In an example, the electrosurgical generator is operable in a triggered mode using a cardiac signal trigger and provides the operator with an estimate of remaining time that is calculated in light of a calculated cardiac rate.

Abstract: Systems and methods to determine an indication of patient dehydration are disclosed, including receiving first and second physiologic information of a patient, the first physiologic information including heart sound information of the patient and the second physiologic information different than the first physiologic information, and determining the indication of patient dehydration using the received first and second physiologic information.

Abstract: Examples herein include prosthetic valves, valve leaflets and related methods. In an example, a prosthetic valve is included having a plurality of leaflets. The leaflets can each have a root portion and an edge portion substantially opposite the root portion and movable relative to the root portion. The leaflets can include a fibrous matrix including polymeric fibers having an average diameter of about 10 nanometers to about 10 micrometers. A coating can surround the polymeric fibers within the fibrous matrix. The coating can have a thickness of about 3 to about 30 nanometers. The coating can be formed of a material selected from the group consisting of a metal oxide, a nitride, a carbide, a sulfide, or fluoride. In an example, a method of making a valve is included. Other examples are also included herein.

Abstract: Novel and versatile apparatuses for delivering one or more of thermal ablation and irreversible electroporation therapies to target tissue. In some examples, a device includes at its distal end a plurality of electrodes that can be advanced or retracted to pierce patient tissue, with a variable position and size shaft electrode provided near the distal end of the device to allow manipulation of therapy fields to achieve various tissue destruction field shapes. A number of method of use examples are described as well.

Abstract: Novel and versatile apparatuses for delivering one or more of thermal ablation and irreversible electroporation therapies to target tissue. In some examples, a device includes at its distal end a plurality of electrodes that can be advanced or retracted to pierce patient tissue, with a variable position and size shaft electrode provided near the distal end of the device to allow manipulation of therapy fields to achieve various tissue destruction field shapes. A number of method of use examples are described as well.

Abstract: In some aspects, the disclosure pertains to injectable particles that contain at least one pH-altering agent that is configured to be released from the injectable particles in vivo, upon embolization of an intratumoral artery of a tumor with the injectable particles. In certain instances, the pH altering agent may be a basic agent having a pH value of 7.5, a buffering agent having a pKa value of 7.6 or more, or both. Other aspects of the disclosure pertain to preloaded containers containing such injectable particles and methods of using such injectable particles.

Abstract: In some aspects, the disclosure pertains to injectable particles that contain at least one pH-altering agent that is configured to be released from the injectable particles in vivo, upon embolization of an intratumoral artery of a tumor with the injectable particles. In certain instances, the pH-altering agent may be a basic agent having a pH value of 7.5, a buffering agent having a pKa value of 7.6 or more, or both. Other aspects of the disclosure pertain to preloaded containers containing such injectable particles and methods of using such injectable particles.

Abstract: Methods and devices for issuing ablation therapy using a cardiac signal as a trigger for therapy delivery. The cardiac signal itself may be analyzed before and/or between pulsed electrical field outputs to determine when, relative to fiducials within the cardiac signal, the output can safely be delivered. In some examples, the timing of therapy delivery is tailored to the patient's current cardiac state, such as the cardiac rate. In other examples, triggering signals can be analyzed to ensure that the trigger itself is appropriately detected.

Abstract: Ablation probes and methods of their use. Example probes include probe circuits configured to provide identifying information for the probe itself. The probe circuits may sense probe usage and/or age to determine probe end of life (EOL). In response to EOL, the probe circuit generates an output indicating EOL. The probe electronic circuit may also be configured to monitor probe usage via impedance or other features, independent of such operation by an ablation pulse generator.

Abstract: In some aspects, the present disclosure pertains to methods of treating a tissue volume comprising (a) administering an implantable composition comprising a releasable membrane-active agent to a target site such that the membrane-active agent is locally released to the tissue volume and (b) performing irreversible, reversible and/or thermal treatment by application of a pulsed electric field to the tissue volume. In other aspects, the present disclosure pertains to embolic compositions that comprise releasable membrane-active agents.

Abstract: Systems and methods for performing and controlling ablation therapy. Examples provide adaptive therapy outputs that allow a user to select among various feedback parameters, parameter limits, and therapy profiles, to be implemented by an ablation system. The ablation system adaptively issues therapy by monitoring one or more feedback parameters to determine changes to make to therapy outputs.